Cephalexin Levels in Human Bile in Presence of Biliary Tract Disease

Sales, J. E. L.; Sutcliffe, Marion; O'Grady, F.

doi:10.1136/bmj.3.5824.441

Cited by 32 publications

(14 citation statements)

References 7 publications

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“…These levels are much higher than the minimum inhibitory concentrations for common pathogens. Although ceforanide is predominantly excreted in the urine (7), our data show that like other cephalosporins it reaches high concentrations in bile (1,(3)(4)(5)(6).…”

Section: Resultsmentioning

confidence: 94%

Biliary levels of ceforanide

Kenady¹,

Ram²

1983

Antimicrob Agents Chemother

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Ceforanide levels in plasma, gallbladder bile, gallbladder tissue, and common bile duct were studied in 10 patients with normal biliary tracts and in 35 patients with biliary disease at various intervals after intravenous injection of 1 g of the drug. Peak blood levels were obtained within 1 h of administration (mean, 67 +/- 15 micrograms/ml). Patients with a normal bilary tract, as well as patients with chronic cholecystitis and a patent cystic duct, achieved high gallbladder bile levels of ceforanide within 2 h (mean, 76 +/- 25 micrograms/ml) and attained even higher levels by 4 h (mean, 182 +/- 51 micrograms/ml). However, all patients with chronic cholecystitis and an occluded cystic duct had very low drug concentrations in the gallbladder bile (14 +/- 7 micrograms/ml at 2 h). Despite this difference in gallbladder bile levels, ceforanide levels of 21 +/- 3 micrograms/g were achieved at 1 to 3 h in gallbladder tissue in both groups with chronic cholecystitis. The concentration of ceforanide in common bile duct was 149 +/- 59 micrograms/ml at 2 h after administration, with levels over 60 micrograms/ml present from 1 to 4 h after administration. These results indicate that ceforanide reaches high levels in the biliary tract. Its potential value in the prevention and treatment of biliary infections should be assessed.

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Section: Resultsmentioning

confidence: 94%

Biliary levels of ceforanide

Kenady¹,

Ram²

1983

Antimicrob Agents Chemother

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“…After 5 doses of 500 mg per os, the concentration of cephalexin in gallbladder bile of patients with cholecystitis was 14-90 Ìg/ml if the gallbladder showed radiologic function and 1-27 Ìg/ml if it was radiologically nonfunctional. Serum levels were 3 Ìg/ml or less, indicating an excellent concentration [45]. In the presence of obstruction of the common duct, no drug was detectable in bile.…”

Section: Cephalexinmentioning

confidence: 93%

“…In the presence of obstruction of the common duct, no drug was detectable in bile. Bile cephalexin was enhanced by the simultaneous administration of probenecid and decreased as much as 10-fold in patients with hepatic dysfunction [45,46].…”

Section: Cephalexinmentioning

confidence: 99%

Biliary Excretion of Antimicrobial Drugs

Karachalios

Charalabopoulos²

2002

Chemotherapy

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The development of drugs able to prevent and cure bacterial infections is one of the 20th century’s major contributions to human longevity and quality of life. Antibacterial agents are among the most commonly prescribed drugs of any kind worldwide. Used appropriately, these drugs are lifesaving. To eliminate an infection as rapidly as possible, a sufficient concentration of the drug(s) chosen must reach the site of infection. Serum/tissue concentration is a result of various parameters such as absorption, excretion, protein binding and metabolic inactivation. Biliary excretion is an important route for the elimination of some drugs and drug metabolites in humans. Thus, drugs with a high bile concentration are indicated for the treatment of gallbladder infectious diseases. We present a review of a large number of antimicrobial agents most commonly used in daily clinical practice, with regard to their biliary excretion.

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“…This contrasts with ampicillin [M o r t im e r et ul., 1969] which was detected in the gall-bladder bile of only half of their patients with radiol ogically non-functioning gall-bladders. Oxytetracycline, erythromycin and spiramycin evidently penetrate the non-functioning gall-bladder to an even lesser extent [Levrat et al, 1957], although cephalexin in inhibitory concentrations was found in all cases [Sales et al, 1972].…”

Section: Discussionmentioning

confidence: 99%

Excretion of Clindamycin in the Bile of Patients with Biliary Tract Disease

Sales¹,

Sutcliffe²,

O'Grady³

1973

Chemotherapy

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Clindamycin (Dalacin C) was given to 22 patients undergoing surgery for chronic cholecystitis. Samples of bile were taken either directly from the gall-bladder and common duct or post- operatively from a T tube. Clindamycin was rapidly excreted in the bile, peak levels being found after 2 h. High concentrations were found in the bile of the common duct and in those patients with radiologically functioning gall-bladders. The gall-bladder bile of those patients with radiological non-function were all found to contain clindamycin but in a lower concentration than the functioning gall-bladders. The penetration of clindamycin into the bile in radiologically non-functioning gall-bladders in concentrations exceeding the minimum inhibitory concentrations for Salmonella suggests that a trial of its use in typhoid carriers would be justified.

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Cephalexin Levels in Human Bile in Presence of Biliary Tract Disease

Cited by 32 publications

References 7 publications

Biliary levels of ceforanide

Biliary levels of ceforanide

Biliary Excretion of Antimicrobial Drugs

Excretion of Clindamycin in the Bile of Patients with Biliary Tract Disease

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